重症敗血症/敗血症性ショックに対するPMMA-CHDF(<特集>アフェレシスの新しい適応をめぐって)

概要

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A wide variety of blood purifications intended for removal of humoral mediators such as cytokines are performed in patients with severe sepsis/septic shock. While high-volume hemofiltration (HVHF), hemofiltration using high cut-off membrane filters, and direct hemoperfusion with an immobilized polymyxin-B column (PMX-DHP) are representative types of this treatment, we perform continuous hemodiafiltration using a polymethylmethacrylate membrane hemofilter (PMMA-CHDF), which features excellent cytokine-adsorbing capacity, for the treatment of severe sepsis/septic shock. PMMA-CHDF efficiently removes various cytokines from the bloodstream, resulting in early recovery from shock and a high survival rate. PMMA-CHDF also removes anti-inflammatory cytokines from the blood stream, suggesting that it might improve immunoparalysis as well. These findings suggest the clinical usefulness of PMMA-CHDF intended for cytokine removal in severe sepsis/septic shock.
2010-10-31